Case Manager

Point C

About The Position

Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company. Point C is seeking a compassionate and detail-oriented Case Management Nurse to support patients on their journey to better health and well-being. In this role, you’ll serve as a critical liaison between patients, providers, care teams, and community resources—ensuring continuity of care and adherence to treatment plans.

Requirements

Current standing as a registered nurse (RN) or licensed practical nurse (LPN) required
5 years of experience in a clinical or community resource setting/care coordination required
2 years of case management experience required
Highly organized with ability to keep accurate notes and records
Evidence of essential leadership, communication, education and counseling skills
Proficient computing skills and the ability to learn new systems
Exemplary telecommunication skills
Maintains high level of professionalism and confidentiality

Responsibilities

Create and promote adherence to treatment plans, as developed by patients’ healthcare providers
Create and maintain accurate, detailed clinical patient reports for clients and carriers
Monitor and document adherence to treatment plans, evaluate effectiveness, monitor patient progress in a timely manner
Increase continuity of care by managing relationships with tertiary care providers, transitions-in-care, and referrals
Increase patients’ ability for self-management and shared decision making
Increase comprehension through culturally and linguistically appropriate education
Assist with medication reconciliation
Connect patients to relevant community resources, with the goal of enhancing patient health and wellbeing.
Serve as the contact point, advocate, and informational resource for patients, care team, family/caregiver(s), stop-loss carrier, and community resources
Assess a patient’s unmet health and social needs
Acknowledges patient’s right on confidentiality issues, always maintains patient confidentiality and follows HIPAA guidelines and regulations